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  • January 14, 2022

    By Allison Larson, MD

    Whether you’re a winter sports enthusiast or spend the season curled up by the fireplace, the low humidity, bitter winds, and dry indoor heat that accompany cold weather can deplete your skin’s natural moisture. Dry skin is not only painful, uncomfortable, and irritating; it also can lead to skin conditions such as eczema, which results in itchy, red, bumpy skin patches. 

    Follow these six tips to prevent and treat skin damage caused by winter dryness.

    1. Do: Wear sunscreen all year long.

    UV rays can easily penetrate cloudy skies to dry out exposed skin. And when the sun is shining, snow and ice reflect its rays, increasing UV exposure. 

    Getting a sunburn can cause severe dryness, premature aging of the skin, and skin cancer. Snow or shine, apply sunscreen before participating in any outdoor activity during the winter—especially if you take a tropical vacation to escape the cold; your skin is less accustomed to sunlight and more likely to burn quickly.

    The American Academy of Dermatology (AAD) recommends sunscreen that offers protection against both UVA and UVB rays, and offers a sun protection factor (SPF) of at least 30.

    That being said, if you are considering laser skin treatments to reduce wrinkles, hair, blemishes, or acne scars, winter is a better time to receive these procedures. Sun exposure shortly after a treatment increases the risk of hyperpigmentation (darkening of the skin), and people are less likely to spend time outside during the winter.

    Related reading: 7 Simple Ways to Protect Your Skin in the Sun

    2. Do: Skip products with drying ingredients.

    Soaps or facial products you use in warm weather with no issues may irritate your skin during colder seasons. This is because they contain ingredients that can cause dryness, but the effects aren’t noticeable until they’re worsened by the dry winter climate.

    You may need to take a break from:

    • Anti-acne medications containing benzoyl peroxide or salicylic acid
    • Antibacterial and detergent-based soap
    • Anything containing fragrance, from soap to hand sanitizer

    Hand washing and the use of hand sanitizer, which contains a high level of skin-drying alcohol, cannot be avoided; we need to maintain good hand hygiene to stop the spread of germs. If your job or lifestyle requires frequent hand washing or sanitizing, routinely apply hand cream throughout the day as well.

    During the COVID-19 pandemic, I have seen a lot of people develop hand dermatitis—a condition with itchy, burning skin that can swell and blister—due to constant hand washing. Sometimes the fix is as simple as changing the soap they're using. Sensitive-skin soap is the best product for dry skin; it typically foams up less but still cleans the skin efficiently.

    3. Do: Pay closer attention to thick skin.

    Areas of thin skin, such as the face and backs of your hands, are usually exposed to the wind and sun the most. It’s easy to tell when they start drying out. But the thick skin on your palms and bottoms of your feet is also prone to dryness—and tends to receive less attention.

    When thick skin gets dry, fissures form. You’ll see the surface turn white and scaly; then deep, linear cracks will appear. It isn’t as pliable as thin skin. When you’re constantly on your feet or using your hands to work, cook, and everything in between, dry thick skin cracks instead of flexing with your movements. 

    To soften cracked skin, gently massage a heavy-duty moisturizer—such as Vaseline—into the affected area once or twice a day. You can also talk with your doctor about using a skin-safe adhesive to close the fissures and help them heal faster.

    Related reading:  Follow these 5 Tips for Healthy Skin

    4. Don’t believe the myth that drinking more water will fix dry skin.

    Contrary to popular belief, the amount of water or fluids you drink does not play a major role in skin hydration—unless you’re severely dehydrated. In the winter, especially, dry skin is caused by external elements; it should be treated from the outside as well. 

    The best way to keep skin hydrated and healthy is to apply fragrance-free cream or ointment—not lotion—to damp skin after a shower or bath.
    Some people need additional moisturizers for their hands, legs, or other areas prone to dryness.

    While some lotions are made better than others, most are a combination of water and powder that evaporates quickly. Creams and ointments work better because they contain ingredients that can help rebuild your skin barrier. 

    Look for products with ceramide, a fatty acid that helps rebuild the fat and protein barrier that holds your skin cells together. The AAD also recommends moisturizing ingredients such as:

    • Dimethicone
    • Glycerin
    • Jojoba oil
    • Lanolin
    • Mineral oil
    • Petrolatum
    • Shea butter

    For severely dry skin, you can try a “wet wrap” technique:

    1. Rinse a pair of tight-fitting pajamas in warm water and wring them out so they’re damp, not wet.
    2. Apply cream or ointment to your skin.
    3. Put on the damp pajamas, followed by a pair of dry pajamas, and wear the ensemble for several hours.

    Dampness makes your skin more permeable and better able to absorb hydrating products. If the wet wrap or over-the-counter products aren’t working for you, talk with a dermatologist about prescription skin hydration options. 

    Drinking more water isn’t the answer to dry winter skin. The best solution is to apply fragrance-free cream or ointment directly to damp skin. Get more cold weather #SkinCareTips from a dermatologist in this blog:
    Click to Tweet


    5. Don’t confuse skin conditions with dryness.

    Skin conditions are often mistaken for dry skin because peeling or flaking are common symptoms. Redness of the skin or itching in addition to dryness and flaking indicates a skin condition that may need more than an over-the-counter moisturizer.

    Skin cells are anchored together by a lipid and protein layer (like a brick and mortar wall). With very dry skin, the seal on this wall or barrier is not fully intact and water evaporates out of the skin’s surface. The skin will become itchy and red in addition to scaly or flaky. If you experience these symptoms, visit with a dermatologist.

    6. Don’t wait for symptoms to take care of dry skin.

    Be proactive—the best way to maintain moisture is to apply hydrating creams and ointments directly to your skin on a regular basis. Start by applying them as part of your morning routine. Once you get used to that, add a nighttime application. And carry a container of it when you’re on the go or keep it in an easily accessible location at work.


    You can’t avoid dry air, but you can take precautions to reduce its harsh effects on your skin. If over-the-counter products don’t seem to help, our dermatologists can provide an individualized treatment plan. Hydrated skin is healthy skin!

    Does your skin get drier as the air gets colder?

    Our dermatologists can help.

    Call 202-877-DOCS (3627) or Request an Appointment

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  • May 02, 2019

    By MedStar Health

    You are invited to a one-week (40 hour) summer intensive workshop. This workshop will focus on biostatistics, observational epidemiology, and design of clinical research.  This workshop may be eligible for tuition assistance benefits or Graduate Medical Education (GME) funds.

    Topics covered include:

    • Introduction to Biostatistics
    • Working with SPSS
    • Selecting Statistical Tests
    • Introduction to Regression Analysis
    • Study Design & Conducting Clinical Research
    • Power & Sample Size
    • Survival
    • EMR/HER Cohort Discovery Research

    Workshop Instructor:
    Nawar Shara, PhD

    July 8-12, 2019
    9:00 a.m. – 5:00 p.m.
    Georgetown University
    Dahlgren Memorial Library
    3900 Reservoir Road, NW
    Washington D.C., 20007

    Registration Fee:

    • $1,200 for Faculty & Staff
    • $800 for Residency and Fellowship Programs
    • Group rates available

    Registration Deadline: June 24, 2019 
    Questions? Contact Rebecca Ho at

    Space is limited. Register Today!

  • April 30, 2019

    By Erin A. Felger, MD

    The thyroid is a central gland of the endocrine system. It produces hormones that control your metabolism, which is how our body breaks down and processes the energy received from food.

    A thyroid nodule is an abnormal growth of thyroid cells that forms a lump within the thyroid gland. Most thyroid nodules cause no symptoms and often are found during a routine examination or an imaging test for an unrelated reason. Sometimes, patients themselves find a nodule after noticing a lump in their neck.

    According to the American Thyroid Association, nine out of 10 nodules are noncancerous. Thyroid nodules that are known or thought to be cancerous typically are first treated with thyroid surgery—the most common being transoral thyroid surgery.

    Dr. Felger discusses transoral thyroid surgery in the Medical Intel podcast.

    What Is Transoral Thyroid Surgery?

    Transoral thyroid surgery is a procedure we use to remove the thyroid by going through the mouth, as opposed to making open incisions in the neck during traditional surgery. This allows people to avoid not only incision scars but also hypertrophic and keloid scars, which occur when scars thicken because of an abnormal response to trauma or injury.

    We saw one woman who had a fairly large nodule in her neck that needed to be removed. Initially, she worried it would result in a large scar until she learned about transoral surgery. The patient eventually opted for the procedure and returned a week later thrilled with her recovery and the lack of scarring.

    Transoral thyroid surgery allows people to remove #thyroid nodules while avoiding incision scars, says Dr. Erin Felger. via @MedStarWHC. Learn more.

    Click to Tweet

    Patients can begin preparing for transoral thyroid surgery by scheduling a consultation with a surgeon. During this time, the surgeon will provide the patient with a list of things that must be completed prior to the day of surgery, which often includes:

    • Electrocardiography (ECG or EKG), the recording of electrical activity of the heart
    • Lab tests
    • Physical exam
    • Imaging tests, such as an X-ray

    Patients typically are back to work anywhere from a few days to a week after surgery. We provide them with an oral care regimen immediately after surgery, which includes a salt water mouth rinse after each meal and before bed. Some things patients can expect to have minor difficulty with for the next few months include difficulty swallowing and numbness around the mouth and chin where the incisions were made.

    Expert Care at MedStar Washington Hospital Center

    We are one of the only hospitals in the Washington, D.C., area to offer transoral thyroid surgery. Furthermore, we use a team approach in which endocrinologists; ear, nose, and throat doctors; nuclear medicine doctors; and radiologists work together to provide patients the most comprehensive care possible.

    Transoral thyroid surgery not only treats people with cancerous thyroid nodules but also leaves no scarring. Make sure to speak to a doctor to discover whether you are a candidate.

    Call 202-877-3627 or click below to make an appointment with an endocrine surgeon.

    Request an Appointment

  • April 26, 2019

    By MedStar Health

    Maintaining healthy cholesterol levels is important, as it’s a primary risk factor for heart disease, the leading cause of death in the U.S.

    Cholesterol levels are made up by what’s called a lipid profile, which consists of four main parts:

    • Total cholesterol: all the cholesterol in your blood
    • Low-density protein (LDL): “bad” cholesterol that leads to plaque buildup or blood clots in the artery wall
    • High-density protein (HDL): “good” cholesterol that helps remove bad cholesterol from your blood
    • Triglycerides: a kind of fat that develops in the body due to excess calories

    While it’s important to have all cholesterol levels at a healthy mark, maintaining an appropriate HDL is the most critical. Genetics and lifestyle factors are the main triggers for high cholesterol. Because genetics can’t be controlled, ensuring your lifestyle is cholesterol-friendly is critical for avoiding high cholesterol.

    Lifestyle Tips to Manage High Cholesterol

    While medication is necessary in some cases, lifestyle modifications should be the cornerstone of any cholesterol management strategy. Below are three key lifestyle modifications to keep your cholesterol levels in check.

    High #Cholesterol is a primary risk factor for #HeartDisease. Learn what lifestyle modifications you can make today to keep your cholesterol levels in check via @MedStarHealth. #LiveWellHealthy
    Click to Tweet

    Avoid Saturated and Trans Fats

    If you consume a diet that’s high in saturated fat or trans fat, you increase your risk of developing high cholesterol. Saturated fat is found mostly in animal products, such as meat, butter, and cheese. Trans fat is found in processed, fried, and baked goods.

    We recommend consuming saturated fat at a rate of less than seven percent of your total caloric intake. Patients who have followed this guideline have seen their LDL levels go down by eight to 10 percent. The Food and Drug Administration, thankfully, banned trans fats from U.S. restaurants and grocery stores in 2018.


    Exercising is an effective way to lower your LDL levels, boost your HDL levels, and lose weight. We suggest doing exercises that you enjoy, such as walking, jogging, or lifting weights, for at least 30 minutes a day, four to five days a week. Studies show that when your body mass index (BMI) is above 30, it raises blood cholesterol and triglyceride levels, and lowers HDL levels. To further increase your chances of losing weight, and lowering your BMI, make sure you are burning more calories than you are consuming.

    Don’t Smoke

    Smoking affects your blood vessel walls and lowers your HDL levels, which increases your risk of heart disease, as it can lead to plaque buildup in your arteries and the narrowing of blood vessels. And worse yet, the plaques can rupture and cause acute heart attacks. If you quit smoking, you can reduce your heart disease risk by half within a year. If you smoke and need help quitting, make sure to speak to your doctor about smoking cessation programs in your area.

    Medication for High Cholesterol

    Sometimes diet and exercise aren’t enough, and medication is necessary to bring your cholesterol levels down. Statin medications are a good way to lower LDL levels—the most potent statins have lowered LDL levels by up to 50 percent—and block the way LDL is produced and recycled within the body.

    We also have newer blockbuster drugs such as Repatha®, which is injectable medication. However, we typically reserve medications like Repatha® for high-risk patients or people who can’t tolerate statins. Bile acid resins and fibrates are other effective medications that block the way your body absorbs cholesterol when you eat.

    How Often Should I Get My Cholesterol Checked?

    People 18 and older with average high cholesterol risk should get their cholesterol levels checked at least once every five years. Individuals who have or had high blood pressure typically see us much more frequently. Make sure to speak to your doctor to set up recurring checkups if you’ve previously experienced high cholesterol levels.

    Where Can I Find More Information about High Cholesterol Risk Factors and Treatment Options?

    Watch our live interview with Dr. Kerunne Ketlogetswe, a cardiologist at MedStar Heart & Vascular Institute.

    Maintaining good cholesterol levels is an important way to keep your heart healthy. Make sure to consider these lifestyle modifications—and medications, if needed—to do so.

    Want to learn more about heart health? Click below to learn more about the services offered at MedStar Heart & Vascular Institute.

    Learn More

  • April 23, 2019

    By Konstantinos Loupasakis, MD

    Lupus erythematosus, or lupus, is an autoimmune disease that can damage practically any part of the body, including the skin, joints, blood cells, and vital organs (heart, kidneys, brain, liver, and lungs). When a person has lupus, their immune system is overly active and disorganized, functioning as if it’s responding to an injury or infection—even though there isn’t one.

    Presentation ranges widely from person to person, but it can include:

    • Arthritis, particularly peripheral joints (such as the hands, wrists, elbows, knees, feet, and ankles) manifesting with joint pain, swelling, and stiffness
    • Hair loss (in patches or in a more diffuse pattern)
    • Inflammation of the heart, brain, kidneys, and eyes
    • Skin rashes on the face, the most common being the butterfly rash (named because of its shape)

    Symptoms of lupus, which affects about 1.5 million Americans, often occur gradually, but episodes of acute worsening (“flare-ups”) can develop quickly as well. If an individual notices symptoms, they should visit with a rheumatologist to be tested for lupus so they can receive treatment, if necessary.

    Let’s examine who’s most at risk for the disease, how we diagnose and treat it, what happens without treatment, and what can be done to lower the risk of symptom flare-ups.

    Dr. Loupasakis discusses lupus in the Medical Intel podcast.

    Who’s most at risk for lupus?

    About nine of 10 adults with lupus are women—most of which we see are in their 20s and 30s. There’s also a genetic predisposition to the disease. We’ll often see lupus patients who have a first-degree relative (such as a parent, sibling, or child) with lupus.

    Additionally, lupus affects African-Americans more than other ethnic groups. Although the reasoning isn’t entirely understood, some researchers point to a genetic component, such as African-Americans having a more severe type of lupus. Social disparities could play a role as well, however, such as African-Americans’ access to health care compared to other ethnic groups.

    How is lupus diagnosed?

    A lupus diagnosis can be made during a doctor’s visit where we conduct:

    • Analysis of past symptoms
    • Blood and urine tests
    • A physical exam
    • X-rays of any joints that are affected by arthritis or magnetic resonance imaging (MRI), if necessary

    #Lupus is an autoimmune disease that can cause symptoms ranging from face #rashes to #arthritis. To be tested for the disease, people can have blood and urine tests and a physical exam. Learn more. via @MedStarWHC

    Click to Tweet

    How is lupus treated?

    Medications exist that can decrease inflammation and prevent affected organs from suffering permanent damage as long as the disease is treated early. The most common include:

    • Oral tablets
    • Injectable medications that patients can self-administer at home
    • Intravenous (IV) infusions that are provided by a medical professional

    These medications can take anywhere from a few weeks to several months to take full effect. To ensure they are effective, patients have frequent follow-up appointments, during which we monitor whether their symptoms are improving and perform any necessary screenings to evaluate if their condition has improved.

    Corticosteroids (aka “cortisone” or “steroids”), meanwhile, are reserved for patients with acute lupus flare-ups. These medications have a more immediate effect that makes them appealing as an acute treatment or rescue therapy; however, an effort is always made to taper them off as quickly as possible in order to avoid complications that result from long-standing steroid use.

    It’s important that we provide good support to patients while they wait for their medications to begin working. If patients experience a lot of pain while waiting for their medication to kick in, they might be prescribed painkillers to help. Furthermore, we provide patients with emotional and psychological resources, such as instructions on how to participate in support groups or referrals to psychiatry or psychotherapy, because dealing with a chronic disease can lead to anxiety and depression.

    A success story

    I always recall the case of a very sick patient, a woman in her 20s who grew up with lupus, having taken medications for most of her life and having suffered multiple flares over the years. Her lupus had been reasonably controlled until she left for college, when her lupus became very active, possibly because of inconsistent use of her medications and increased emotional and physical stress. She presented to the hospital with inflammation in her joints, skin, and brain, which is a severe and relatively rare manifestation, and she couldn’t recognize our medical care team upon arriving at the hospital.

    We treated her aggressively with high doses of steroids and escalation of her maintenance lupus medications, and the inflammation improved within 24 hours. Over the following months, we were able to get her disease completely under control with frequent follow up visits and close monitoring. I will never forget her smile and relief for being able to be back at college and enjoying life with her peers again.

    What if lupus is left untreated?

    Lupus is a multisystem disease, which means it can potentially affect various parts of the body—and cause permanent damage, if left untreated. Although most lupus patients we see typically have arthritis, skin rashes and fatigue/malaise, many of them can also develop inflammation of vital organs, such as the kidneys, heart and brain. In fact, up to 50 percent of patients can develop kidney involvement during their illness, usually within the first few years of disease onset. This can lead to permanent kidney failure and can require lifelong dialysis if not treated early.

    While patients can have a hard time knowing whether they have complications such as kidney inflammation (lupus nephritis), we always suggest they stay aware of symptoms, such as swelling of the ankles or face, or urine that is foamy or bloody. Patients should follow up closely with a doctor to identify the cause of these subtle changes.

    Related reading: Dr. Loupasakis discusses 17 facts about lupus you might not know, but should in this CreakyJoints article.

    Can you prevent lupus?

    We are not aware of anything that can prevent the development of lupus. However, cigarette smoking, among other environmental exposures, has been reported to increase the risk.

    Importantly, there are things that people who already have lupus can do to help prevent their disease from becoming active. For example, patients should use sunscreen with a sun protection factor (SPF) of 30 or higher, as too much sun exposure can be a trigger for lupus symptoms.

    Numerous people with lupus visit MedStar Washington Hospital Center, so we have vast experience treating the disease. We use a team approach, working closely with specialties such as nephrologists, neurologists, and cardiologists, which is important because lupus can affect many different parts of the body. As a result, an expert is always involved in a patient’s care—no matter what part of the body is affected.

    Lupus is a condition that requires medical attention to manage symptoms. Thankfully, we have a wide range of treatments patients can use to alleviate their pain and get back to their everyday lives.

    Call 855-546-1974 or click below to make an appointment with a rheumatologist.

    Request an Appointment

  • April 19, 2019

    By MedStar Health

    Do you enjoy running, biking, swimming, or all three? Maybe you’re a runner looking for a challenge. Why not try a triathlon?

    Triathlons are events that combine three different sports. Traditionally, triathlons include swimming, biking, and running—in that order. It’s an exciting event that pushes athletes out of their comfort zone and challenges the limits of their physical capability.

    Ready to sign up for your first tri? Awesome! Keep reading for training tips for each of the three sports. Still on the fence? Maybe by the end of this, you’ll be ready to take on the challenge.

    How Long is a Triathlon?

    First things first, you have to pick a triathlon. You’ll want to consider which distance is best for you. There are four classic triathlon distances:

    • Sprint: 16 miles—the distances vary, but in general, the swim portion is about 0.5 miles (750 m), the bike is 12.4 miles (20 km), and the run is 3.1 miles (5 km).
    • Olympic: Approximately 32 miles—features a 0.93-mile (1.5 km) swim, a 24.8-mile (40 km) bike, and a 6.2-mile (10 km) run.
    • Half Ironman: 70.3 miles—perfect for a race veteran looking for a challenge. The swim is 1.2 miles (3.8 km), the bike is 56 miles (90 km), and the run is 13.1 miles (21.09 km).
    • Ironman: 140.6 miles—Ironman competitions take place all over the world. The annual world championship is held in Kona, Hawaii. This race consists of a 2.4-mile (3.8 km) swim, 112-mile (180 km) bike, and a 26.2-mile (42.2 km) run.

    If you’re just starting out, you’ll probably want to begin with a sprint or Olympic triathlon before tackling the half or full Ironman. If you do decide to go for an Ironman, you’ll want to include a shorter distance triathlon as part of your training plan.

    In the Baltimore and Washington, D.C., area, triathlon season is May through October. Athletes will usually spend the first season on a Sprint or Olympic race. If you’re up for the challenge, tackle a half Ironman in the second season and progress to a full Ironman. Training for an Ironman is a 12- to 24-month process.

    How to Get the Most Out of Your Triathlon Training

    When deciding which triathlon to compete in, consider what you want to get out of the race. Look for a challenge, but make sure you can commit the time to train. The longer the race, the more time you’ll need to spend training.

    • Sprint: two to five hours training per week
    • Olympic: three to seven hours training per week
    • Half Ironman: eight to 12 hours training per week
    • Ironman: 10 to 20 hours training per week

    Your training plan should be realistic and manageable. Be sure to find a plan that fits your lifestyle. Aim to do at least two workouts per discipline each week – the distance and duration will vary depending on the race. You should start training with shorter distances, ramping up to longer distances and durations as the race approaches.

    5 Tips to Be a More Confident Swimmer

    Whether you can channel your inner Michael Phelps, or you feel like a fish out of water, don’t skip your swim workouts. The swim portion of the triathlon tends to be the most difficult and uncomfortable for many athletes—and it’s the first event in every triathlon!

    You’ll want to start your race strong and confident. Your training is the key to feeling comfortable and confident during your swim.

    Start simple. Begin by swimming for 15 minutes, taking breaks at the wall as needed. Gradually build up your swim time, aiming for 20 to 30 minutes continuously. The key to a successful swim is to be relaxed and confident in the water.

    • Breathing: Find a breathing rhythm that allows you to comfortably inhale and exhale without stopping.
    • Body Position and Balance: Practice your floating. Swimming with your head, hips, and legs on the surface will make your stroke more efficient. Practice staying afloat while you breathe without rotating your whole body to the side.
    • Selecting Your Stroke: Swim freestyle as much as possible and use backstroke when you need a break. Breaststroke is not recommended for triathlons. The swim portion can be crowded, and the breaststroke increases the likelihood you’ll kick someone swimming next to or behind you.
    • Practice in Open Water: Plan to swim in open water at least twice as part of your training. Swimming in open water is quite different from swimming in a pool, and swimming in open water causes anxiety for a lot of people. If you panic the first time you swim in open water, you’ll want that to be during training—not on race day. Practicing an open water swim allows you to channel that anxiety, move on, and not panic. In addition, never swim in open water by yourself.
    • Take Lessons: If you’re unable to master the swim on your own, consider attending a clinic or taking lessons. There are swim instructors and courses designed specifically for triathletes.

    During your training, mix up your strokes and technique. Use a kickboard and pull buoys to isolate your arms or legs, just be sure you’re not relying on these tools too much. When it comes to race day, you’ll likely still be a little anxious about the swim, but if you’ve done your training, you’ll be fine. Trust your training and try to relax. Next up is the bike. You’ll want to include two bike rides a week in your training plan. One of those rides should include a brick run.

    What is Bricking and Why Should You Do It?

    Bricking is when you do a run right after your bike workout. You’ll want at least one of your bike workouts to include a brick run. The idea is to help train your body and brain to figure out the transition from biking to running. You’re using a lot of the same muscle groups, but the motion and pattern is completely different.

    When you first switch from biking to running, your heart rate will increase because running is more taxing on the cardiovascular system. By practicing this transition, you’re training your body to adjust your breathing rhythm and get to your normal run pace sooner.

    Ideally, you’ll run for about 20 minutes after finishing your bike ride. You don’t need more than 20 minutes to experience the positive effects of bricking.

    Benefits of the Walk and Run Option for Triathletes

    The run is the last discipline of every triathlon after you’ve completed your swim and bike. As we discussed, the transition from the bike to the run will be difficult on your body and your brain. In addition to bricking as part of your training, you may consider the walk and run option on race day.

    This strategy is used by many triathletes. Running is a high-intensity activity and our bodies can only maintain the increased heart rate and temperature for a limited amount of time. By incorporating a period of active recovery—walking—to your routine, the intensity is lowered, and you can sustain it longer.

    You can go as slow as you want during the race. The cut off times are typically generous. For your first triathlon, keep your goal simply to finish. When you cross the finish line, you’ll be overwhelmed by a sense of accomplishment—and maybe even the itch to do another!

    The key to success in each of the three sports is practice. Figure out your run routes, bike routes, and where you can swim. Make a training plan and stick to it. On race day, channel your anxiety and trust your training. You’ll be amazed at what you can accomplish.

    Are you interested in training for an upcoming race or triathlon? Schedule an appointment with Kate Ayoub,PT, and learn how to get fit for race day.

    Learn More

  • April 16, 2019

    By Cesar A. Torres, MD

    People all around the U.S. care for a loved one—whether it’s their mom, dad, grandparent, aunt, or uncle. As a geriatric and house call doctor, I see a variety of common problems these caregivers face, ranging from falls to the misuse of medications.

    Falling is the most common hazard we see in the elderly. These falls can lead to hip fractures, which can have a significant effect on mortality rates over the next year. In fact, nearly 30,000 adults over 65 die annually in the U.S. because of a fall. Seniors are at increased risk for falling because of decreased or impaired vision. There is also a loss of balance and muscle strength, causing them to not lift their feet as high in order to avoid simple obstacles in their path.

    Our geriatric team of doctors and nurses visited one woman who was living alone. We saw that she had no handicap accommodations, despite her weakened muscles and increased falling risk. Additionally, she experienced mild depression that was beginning to impact her adherence to medication. We were able to help her move into a handicap-accessible apartment with wider doorways and handrails. Not only was the new apartment safer for this patient on a physical basis, but her depression also improved dramatically once she was able to move around more due to the safer environment.

    LISTEN: Dr. Torres discusses tips to care for the elderly in the Medical Intel podcast.

    How to Care for Older Relatives at Home

    Many caregivers overlook steps they can take to help their elderly loved ones. Common tips that we provide caregivers include:

    • Reduce clutter in the house: Be aware of rugs and items that are left on the floor, as they can lead to a fall.
    • Have good lighting: Adequate lighting from lamps and light fixtures helps seniors avoid falls from impaired vision.
    • Make sure they wear their glasses: Good vision is critical to elderly people, as they walk around or complete their daily tasks.
    • Make sure they are safe driving: The ability to drive changes with age, as reaction time diminishes, visual and hearing changes occur, and osteoarthritis of the spine can develop and make it difficult for them to turn their head. Consider riding with them occasionally to ensure they are driving safely; and if they aren’t, encourage them to give up their license and make other arrangements for transportation.
    • Minimize time on stairs: Try to minimize the need for your loved one to go up and down stairs by moving them onto a single floor. If this isn’t possible, ensure handrails are installed.
    • Have open communication: It’s important that we don’t just assume our older relatives are doing OK because they’re not asking for help. Many times, they will do everything they can to not bother their family members and friends. The more open communication is, the more likely our loved ones will tell us of a problem.

    #Caregivers can help their elderly relative or friend by reducing clutter in the house, having good lighting, and minimizing their time on stairs. via @MedStarWHC

    Click to Tweet

    Taking Medication Properly

    Some medications make elderly patients feel sleepy or dizzy, which can increase their fall risk and impair their ability to manage their household. These medications commonly include over-the-counter sleep aids and antihistamines such as Benadryl, which help with congestion, sneezing, and hives.

    The elderly also can overuse or misuse them because of forgetfulness. We try to reduce this by keeping track of their pill bottles every day. Additionally, some medication regimens are complicated, so it’s important that we provide the elderly with written instructions and regular conversations on when and how much to take. Using pill boxes that have a compartment for each day of the week or time of day also can help. Plus, there are even smartphone apps out there that can provide reminders on when to take medications.

    Related Reading:  How to Manage Medications in the Elderly

    How We Can Help

    Our team visits patients’ homes, so we have a good sense of any environmental obstacles they face. In fact, we do environmental assessments and make specific recommendations to ensure the senior lives in a safe environment. We also can connect seniors with eye doctors and surgeons, and ear, nose, and throat doctors to help make sure the senior’s sight and hearing are optimal.

    We always suggest that patients have a good relationship with their primary care doctor. Although elderly patients often see specialists for specific conditions, this fragmented care is not in their best interest, because one specialist can prescribe medication that interacts with other medications prescribed by another specialist. A primary care doctor can provide patients with oversight on all their medications.

    Providing proper care for an elderly relative requires caregivers to pay close attention to them and their environment while having open communication. Consider these tips to improve your loved ones’ quality of life and well-being.

    Call 202-877-3627 or click below to make an appointment with a geriatric doctor.

    Request an Appointment